Locking plate fixation versus double plate fixation for the treatment of Schatzker type IV- VI tibial plateau fractures:a meta-analysis

Abstract

[Objective]To systematically evaluate the clinical efficacy of locking plate fixation versus double plate fixation in the treatment of Schatzker type Ⅳ- Ⅵ tibial plateau fractures and provide a theoretical basis for clinical applications.[Method]A computer search was conducted using the CNKI,ⅥP periodical database,Wanfang resource database,PubMed,and Chinese Biomedical Literature service systems,restricted to locking plate fixation and double plate fixation treatment of Schatzker type Ⅳ- Ⅵ plateau fractures in controlled studies published from January 1999 to January 2014. After development of inclusion and exclusion criteria,we screened the literature that met the inclusion criteria to evaluate the methodologic quality of the included studies. Meta- analysis was conducted using RevMan version 5. 2.[Result]Ultimately,four studies met the inclusion criteria,involving 289 patients. One hundred nineteen patients underwent locking plate fixation and 170 patients underwent double plate fixation. Meta- analysis showed significant differences in operative time( MD =- 27. 44,confidence interval [CI][-32. 34,- 22. 54〗,P 0. 000 01),bone union time( MD =- 17. 93,CI [- 24. 39,- 11. 47],P 0. 000 01),full weight bearing time( MD =- 18. 99,CI [- 27. 48,- 10. 51],P 0. 000 01),and length of hospital stay( MD =- 7. 20,CI [- 9. 73,- 4. 67〗,P 0. 000 01). There were no differences in the excellent and good rates of knee joint fracture reduction( odds ratio= 1. 20,CI [0. 62,2. 35],P = 0. 59) or knee range of motion( ROM; MD =- 5. 0,CI [- 10. 24,0. 24],P = 0. 06).[Conclusion]Compared with double plate fixation,the operative time,bone union time,full weight bearing time,and hospital stay were shorter for locking plate fixation. There were no significant differences in the excellent and good rates of knee joint fracture reduction and knee ROM. However,the included studies were of lower quality; thus,high- quality randomized trials are needed to confirm these findings.

Ähnliche Arbeiten